Your Details Title Title Mr Mrs Ms Miss Mx First Name* Last Name* E-mail * Phone Number * Address & Postcode Details of your loved one Relationship to deceased Title Title Mr Mrs Ms Miss Mx First Name* Last Name* DOB * DOD * Address & Postcode Registered GP details? Has the death been registered? Is the coroner investigating the cause of death? Are there any known infections present such as Covid-19? What committal service is required? Burial Cremation What type of funeral service is required? Direct: Applies to cremations only – this is a non attendance service. Simple: No amendments can be made to the service. (For Burial: Please note that this funeral is only compatible with a graveside service.) Bespoke: Please state your special requirements: For Example, a Horse drawn hearse, Service in a Church, Number of Limousines, Hygienic treatment, Dressing and use of our chapel of rest or an alternative coffin etc. Further details : Sending Thank you for allowing us the privilege to care for your loved one, we will be in contact shortly to confirm your arrangements and provide you with an Estimate based upon the information you have provided. We will require you to complete, sign and return documents before the funeral can go ahead. These can be collected in person from our office, sent via email or sent to you via the post. If you have any questions, please do not hesitate to contact us, 01634 813989.